HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \�`a 1 �°l Permit Number:
RECEIVED
WWW ------ -- o c T 21 2019
Building Permit Application
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION':
Address: 804 NETTLES BLVD
Legal Description: NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 804
Property Tax ID#: 4502-501-0990-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK:'
KW 5
TON 2
SEER 14
''CONSTRUCTIONINFORMATION:
Add
a itiona workto e e orme under this permit—c ec a appy:
HVAC Gas Tank OGas Piping _Shutters Q Windows/Doors
Electric Plumbing O Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 4900.00 Utilities:In Sewer Septic Building Height:
O\NN'E.R/'LESSEE; CONTRACTOR:, .
Name LUCILLE REINKENDORFF Name: MARK A VINES
Address: 804 NETTLES BLVD Company: AZTIL
City: JENSEN BEACH State: FL Address: 2540 S MILITARY TRAIL
Zip Code: 34957 Fax: City: WEST PALM BEACH State:FL
Phone No.772-631-4695 Zip Code: 33415 Fax:
E-Mail: Phone No. 561-433-2197
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS -AZTlLAC.COM
from the Owner listed above) State or County License: CAC049253
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUIPPLEMI,EENTfAL(000NSTRUCTION LIEN LAW,IN.FORMA iI'ON?:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: LUCILLEREINKENDORFF Name:MARKAVINEs
Address: 804 NETTLES BLVD Address: 804 NETTLES BLVD
City: JENSEN BEACH State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2540 S MILITARY TRAIL Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci r or recording our Notice of Commencement.
Signature of Owner/Le see/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 21 day of OCTOBER 26-La by this 21 day of OCTOBER ,20d by
MARK A VINES MARK A VINES
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Producod Produced
Signature of Nota PuStat��� � tate of Florida (Sig ture of NoIYO%
Nota11
ry Public BtsN Of @lOflde
Analisa Whiting Analfa>a yy��I��I��jr�,�1pp
Commission No. My Commi> iBd�G 339912 Commission No. My Comnli�i OG 339912
erw xpires 05/29/2023 Expires05/29/2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17